Tropical small islands are perceived paradise destinations for most tourists, however, small islands are critical biosystems with finite, fragile and vulnerable yet unique set of resources. These features are not highlighted as a defining character that captures small islands spatial challenges and context. Using the DPSIR (Driver-Pressure-State-Impact-Response) framework as an approach to analyze the small island tourism context, a more robust and integrated problem diagnosis was derived from the small island province of Camiguin. The problematic context of tourism activities is centered to the aspect of island sustainability geared towards the understanding of its different sectoral concerns including the socio-cultural, economic, environmental, infrastructural and institutional. Through the DPSIR framework direct and indirect concerns were linked on the problematic context or existing state of tourism activities with insightful relationships to recurring island problems on waste management, marginalization of local communities, food insecurity, unsustainable economic activities, threats in the biodiversity, etc. These problematic conditions were provided with targeted solutions involving a wide-spectrum of activities involving community empowerment and local conservation actions and larger municipal- and provincial-wide policy recommendation encompassing direct and indirect sustainable recommendations all obtained from the careful island tourism analysis guided through the DPSIR framework.